| NPI | 1750450557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE BERNARD ELVOVE Officer 847-362-1367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 060-005834) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |